| Purpose: To observe and evaluate the safety, efficacy and predictability of laser in situ keratomileusis (LASIK) for different level myopia with Wavelight ALLEGRETTO WAVE excimer laser.Methods: A retrospective study was performed on a total of 126 eyes of 63 patients who underwent LASIK between September 2009 and October 2010 in our hospital, Which were followed up over 3 months. All 126 eyes of 63 patients with low to ultrahigh myopia were divided into Group I- low to moderate myopia (<-6.00 D) and Group II- high to ultrahigh myopia (≥-6.00 D) by spherical equivalent refraction. Group I comprised of 72 eyes of 36 patients (22 males ,14 females) with age range 18-40 years (25.81±5.50 years) and spherical equivalent before operation of﹣1.125D～﹣5.875D(﹣4.83±1.00 D); Group II comprised of 54 eyes of 27 patients (13 males ,14 females) with age range 18-40 years (24.41±5.98 years) and spherical equivalent before operation of﹣6.00D～﹣14.375D(﹣7.97±1.88 D)。The preoperative examinations of all patients were composed of the inquiry of oculer and whole body′s related deseases, uncorrected visual acuity, preoperative diopter, pupil diameter, tear break-up time (BUT), Schirmer test,intraocular pressure, corneal topography, corneal depth, examination of anterior segment and fundus; All patients were excluded the contraindications to LASIK. All patients underwent LASIK by the same ophthalmiater. Determine reasonable operative plan according to corneal depth,subjective refraction and pupil diameter of patient. All eyes′Corneal flap swithed up hinge were created with the Moria M2 microkeratome at an intended thickness of 110 or 130μm in all cases, whose left corneal stromal depth were over 280μm. All eyes underwent LASIK with Wavelight ALLEGRETTO WAVE, keep seeing the indicating lamp during the ablation to insure the accuracy of laser; insure Corneal flap no displacement and stable, wear hard eye shield with holes. Drop ocular drugs after operation: use broad-spectrum antibiotics gutta for 7 days, corticosteroid gutta for 12 days(stop generally), sodium hyaluronate for 30 days。The review after operation were carried out 1st day, 3rd day, 7th day, 1st month and 3rd month, which included uncorrected visual acuity(UCVA), computer optometry, intraocular pressure , the restoration of cornea, best corrected visual acuity(BCVA) if the patient′s postoperated UCVA didn′t gain the prospection and the complications.Results: All of operations were well done, there were no free flaps ,partial flaps or buttonholes flaps occurred intraoperatively. There was one eye′s corneal pannus bleeding during operation respectively in two groups, the operations were completed after hematischesis by washing. There were two eyes′haemorrhage under bulbar conjunctiva in Group I and one in Group II, the operations were completed with no special management. Keep 3 months review after operation, all of three eyes′haemorrhage under bulbar conjunctiva were absorbed within 7th day to 14th day. Two eyes′corneal punctate epithelial defects occurred gradually after operation respectively in two groups operation, which were cured by using Recombinant Bovine Basic Fibroblasst Growth Factor from 7 to 14 days. Serious intraoperative and postoperative complications didn′t occur in all cases. To assess the operation′s safety through the percentage between postoperative BCVA and preoperative BCVA. At 3 months postoperatively, the patient′s BCVA 100% in Group I and 98.15% in Group II didn′t decrease, respectively; which indicated that Wavelight ALLEGRETTO WAVE excimer laser were safe enough for different level myopia treatment. Postoperative UCVA was the important index of successful surgery. If it approached 1.0, the standard of common visual acuity, we could determine that the operation was successful and efficient. The percentage of patient′s UCVA over 1.0 was 98.61% in Group I and 90.74% in Group II, respectively; which indicated that the efficacy of high to ultrahigh myopia Group was a little worse than that of low to moderate myopia Group. To evaluate the operation′s predictability through the difference between UCVA 3 monthes after operation and BCVA before operation. The former was statistically significantly better than the latter in this study, which demonstrated that the postoperative UCVA in both groups were generally better than the prospective ones.Conclusion: As the leading corneal refractive surgery, LASIK has found broad clinical application. Excimer laser plays the most important role dring the correction of refractive error. Wavelight ALLEGRETTO WAVE excimer laser belongs to current flying-spot scan excimer laser, providing powerful guarantee for meticulous, rapid ,accurate ablation by its′effective light spot diameter 0.95mm, laser pulse 400Hz,four-dimensional joint spider high-speed pupillary tracking system.The wavefront optimized treatment ablation profile precompensates for the induced spherical aberration through tissue removal in the periphery. This study suggests that on the premise of choose indication strictly by means of a sift, accurate subjective refraction, qualified corneal flap manufacture and normative operative procedure; LASIK for different level myopia treatment with Wavelight ALLEGRETTO WAVE excimer laser was safe, efficient and predictable.
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